Definition:
Absent menstruation means no menstrual flow, or period. Absent menstruation may be: Primary -- no menstruation before age 16 Secondary -- menstruation begins at the appropriate age, but later stops for more than 3 cycles or 6 months
Absent menstruation is called amenorrhea.
Alternative Names:
Missed periods; Lack of menses; Periods - missed; Amenorrhea
Considerations:
Many perfectly healthy females begin to menstruate later than most (the average age is about 13). Pregnancy is often the first thought when a period is missed, but there are many reasons for having a late period. The rate of primary amenorrhea in the United States is less than 1%. The rate of secondary amenorrhea (due to some cause other than pregnancy) is about 4% in the general population. Symptoms associated with amenorrhea depend on the cause and may include:
Common Causes:
Causes of primary amenorrhea: - Delay may be normal if puberty characteristics, such as breast development, are present by age 13
- Birth defects of the female reproductive system
- Lack of an opening in the membrane at the entrance of the vagina (hymen)
- Problem with the hypothalamus or pituitary gland
Factors that can disrupt normal menstruation include: Causes of secondary amenorrhea: - Pregnancy
- Stress and anxiety
- Drastic weight reduction
- Significant weight gain or obesity
- Hormonal imbalance (such as with polycystic ovarian syndrome)
- Endocrine disorders such as thyroid disease or pituitary disease/tumor
- IUD use
- Too much exercise
- Premature ovarian failure
- Menopause (normal for women over age 45)
- Use of birth control pills and other contraceptives
- Uterine scarring, usually from procedures such as dilation and curettage (D and C)
References:
Master-Hunter T, Heiman DL. Amenorrhea: evaluation and treatment. Am Fam Physician. 2006;73:1374-1382.
|